Increasingly, today's children and youth are struggling to manage stress, anxiety, and emotions – complex issues that require complicated solutions. Are health care professionals and programs across Quinte, Prince Edward and Northumberland equipped to handle the rise in mental illness that is affecting the lives of our children?
MATT* SITS WITH HIS HANDS KNOTTED AS HE SPEAKS. He’s articulate and careful with his words, but also visibly nervous when he talks about the transition from Grade 12 and the foster care system into adulthood. Matt is a student at Applewood Academy, a private school in Belleville that combines clinical treatment and traditional education. At one time Matt chronically cut class because, as he put it, “I found it hard to focus and participate in large environments. I couldn’t deal with the crowds.”
But at Applewood, Matt’s anxiety has a specialized treatment and education plan that have helped to set him up for a hopeful and bright future. The fact that Matt has options is a testament to the success of the program.
His classmate, Brandon* who transferred to Applewood when he was eight, agrees. Like Matt, he’s been receiving a variety of mental health, educational and social supports that help him navigate his emotions.
“I understand that I take a minute, breathe, and get through the work, and the end of the day comes eventually,” he says, looking into his lap, a slight smile on his face.
Brandon and Matt aren’t alone. All over our region, children face unique and complex mental health issues, and with the need greater than ever, resources and services are stretched to the limit.
CHILDREN IN DISTRESS
Mental health diagnoses amongst kids are on the rise. The question is why? It’s a simple question but the answer is complicated.
Angela Hearns, Youth Outreach Case Worker at Rebound Child and Youth Services Northumberland, sees children and youth at risk every day. She believes that one reason behind the rise in mental health issues is that today’s youth aren’t receiving the skills they need to steer their lives through to adulthood. This concern is echoed by Marissa Norton, Principal at Applewood Academy. She notes that many of her students don’t know how to model adulthood because they’ve lacked mentors in their lives, and they haven’t received treatment for diagnosed mental health issues.
The increase in diagnoses could also reflect the reality of today’s technology-based world in which children and youth are exposed to more stimuli, stress and higher expectations than ever. At a time when more and more kids seem to be permanently attached to a screen, medical professionals are raising the alarm. They recommend zero screen access for children under five, citing studies that show early exposure to screens slows development and results in a higher likelihood of behavioural issues.i
Carol Beauchamp, Executive Director of Rebound, notices the correlation between social media usage and depression and anxiety in children. “You can only really put it down to the influence of social media,” she says adding, “The young people, they never have the opportunity to switch off these days.”
Her comments reflect the fact that the pressure from social media on children and youth is relentless. It’s a platform of constant comparison and judgment, where kids learn to define themselves through “likes” on Instagram or Facebook. When the “like” button is isn’t clicked, their self-esteem suffers.
“There’s that internal kind of “ickiness” that kids describe – that there’s something wrong – and it takes a toll on their whole physical and emotional well-being,” says Angela Hearns. “They hide it. They have to pretend to be tougher in their social groups.”
On the flip side, social media can offer help and support people suffering from mental illness. New initiatives like #BellLetsTalk shine a light on depression and anxiety and encourage open discussion in the digital space. Awareness of the issues surrounding mental health and social media is growing – schools are launching anti-bullying programs and online support networks are popping up – and with knowledge comes understanding.
BARRIERS TO CARE
By far the biggest problem in the region is the significant shortage of qualified mental health practitioners, with an even smaller pool of providers who specialize in children and youth. “The waiting lists for mental health programs are huge,” says Angela Hearns. Simply put, there isn’t enough supply for demand.
Jeff Waplak, a Clinical Psychologist and Clinical Director of Stevenson, Waplak & Associates, concurs, but also highlights another problem. He believes that children with more complex requirements often see three to five therapists before their real needs, diagnosis and proper medications are pinpointed. “It can also lead to the most complex kids getting to multiple failures before the service level is right,” Waplak says.
Northumberland, Hastings and Prince Edward Counties cover a broad geographical and socioeconomic landscape and as a result, there are challenges to accessing mental health care, especially for lower income families.
Some mental health services aren’t covered under private insurance or provincial health care and the lack of public transportation to and from appointments complicates the problem. Getting to an appointment can be a significant financial burden for lower income families, when you consider how spread out the services are.
“Lack of public transportation…makes it hard [for lower income clients]…so the onus is on the service provider to get service to their area,” says Carol Beauchamp. And for small agencies, that’s a challenge. Rebound has been forced to get creative in order to reach more rural communities. They use recreation centres and libraries to bring the service to the community. But when it comes to accessing doctors and therapists as well as different forms of treatment, lack of public transportation in rural areas poses a problem.
Studies also show that those who live in poverty may also have a higher risk of experiencing mental health issues due to stress, hopelessness, and despair, ii which means the people who need care the most are the least likely to receive it.
All children feel household stress at some point but children living in poverty face unique pressures that isolate them from their peers.
A further barrier to mental health services is that many kids don’t know how to voice their feelings of depression or anxiety and are unaware of how or where to access help. Sadly, delaying treatment can create larger issues for both the practitioner and the patient. And since early intervention in mental health issues is the best possible medicine with the least impact on both child and the healthcare system, getting children into treatment quickly is vital.
WHAT’S AVAILABLE LOCALLY?
What’s the first step to accessing mental health care in the area? Parents can start by taking children and youth to their general practitioners, who can provide medication and general support as well as referrals to other resources. The family doctor can also refer patients to specialized high-level care, like psychologists, psychiatrists and registered counsellors who can provide treatment. The downside is that often the patient is forced to wait for a long time to get an appointment with specialists. When necessary, hospitals are equipped to deliver psychiatric treatment, and local communities also have support groups, discussion forums, and peer support networks that can be especially comforting to children and kids who are confident working in a digital space.
Barriers aside, the Watershed region has several unique mental health programs that are tailored to kids. Rebound is such a program, providing youth with the social and emotional skills to grow through activity-based learning that caters to specific age groups.
“We help them find their internal strengths and then we promote them,” says Angela Hearns. Rebound’s programs, such as Choices (social skills and group discussion), or YOURS (one-on-one support from a youth outreach worker), develop not only tools to cope with mental health issues, but also offer support to clients while they wait for higher-level treatment.
According to Carol Beauchamp, these types of programs give young people the opportunity to work in groups and to develop social skills through activities, building what she calls “their tool kit.” Best of all, clients can self-refer or be referred through doctors, teachers, and other caregivers. Demand for the Rebound programs has nearly doubled over the last year.
As of Fall 2017, Northumberland opened their first walk-in counselling service. Currently, the service is geared more towards adults, but youth between the ages of 16-18 can visit Northumberland Hills Hospital twice a week for on-the-spot treatment when in crisis.
Hastings County offers Open Line, Open Mind, a support line for adults and youth between 16-18, which can also refer patients to other services.
The John Howard Society of Belleville is home to the Quantum program, designed for students who face challenges in high school. The goal of the program is to keep “at risk” youth in school and part of the community by providing individual students with wrap-around support – educational and developmental services coupled with a sustained relationship with a trained youth worker – throughout their high school years.
As a nod to screen worship, HPE (Hastings and Prince Edward County) Children and Youth Services Network taps into technology with a digital Rolodex of handy contact cards that can be printed, downloaded or accessed online, helping youth and kids access and find the right resource to support their need, according to the region they live in.
Belleville is also home to one of just a handful of children-specific residential treatment programs in Canada that treat clients from all over the world. Stevenson, Waplak & Associates provides clinical and social services for Quinte Children’s Homes, a residential-style program where the primary treatment is provided by Parent Therapists – a roster of foster parents trained by Stevenson, Waplak & Associates – who support children with complex mental health and development needs. Children in this care system also have access to doctors, specialists and treatment providers.
When other options have been exhausted, Stevenson, Waplak & Associates also operate the private Applewood Academy Therapeutic Boarding School – home to Brandon and Matt – that offers counselling, therapy, assessments and a broad range of medical and mental health service providers for children and their families. The school, which has about 20-30 students a year, creates individual learning and treatment plans designed to meet the student’s goals for the future. The residential nature of the program, in which students live within the community with Parent Therapists, allows for a broad spectrum of focused care that is suited to the individual.
And students are responding. Brandon credits Applewood’s care for the turnaround in his life and his ability to get an education when the provincial system wasn’t working with his inability to focus. “I’ve had a lot more help than I could have gotten with my parents – from medical stuff to just love and care,” says Brandon. “I got more support. And I wasn’t given up on, even though it took five years to get my medication right.”
WAYS TO MOVE FORWARD
While mental health services and support programs are available in the region, the reality is that demand for these services and programs that help kids cope with their problems and give them the care they need far outweighs the supply. “If we look at mental health services overall, I would say they’re underfunded,” says Carol Beauchamp.
Studies show that money spent on mental health care early on in someone’s life, saves money in the future and that resources are better spent on prevention rather than treatment.
According to Jeff Waplak, the longer a person waits for treatment, the more complex the problems become. His prescription for better care? “Provide the appropriate service now. Improve quality of life.”
Every level of government needs to know that programs like Rebound, Applewood and Quantum, which give kids tangible skills to deal with mental health struggles on their own, are key to a healthy future for children.
Like adults, children and youth with mental health issues feel alone with their struggles. But with an eye towards prevention, supportive care, and access to treatment, the next generation has a better chance of developing the skills they need to succeed and the emotional tools required to navigate the rollercoaster of life.
When asked about his plans for the future, Brandon says with confidence that he’s set his sights on a career in the culinary arts. Matt isn’t so sure, but he acknowledges that he has choices and decisions to make, which makes him both apprehensive and excited.
“You’re going from your childhood and everything’s okay to, okay, now it’s time to see what adult life is.” Adult life will undoubtedly be an abrupt change, but Brandon and Matt will be able to adapt, because adults took the time to notice that what the boys needed wasn’t a reprimand. They needed help, and someone had the patience to help them access it.
Mental health issues are on the rise amongst children and youth but information is power.
FACTS AND FIGURES
• 1 in 5 children and youth in Ontario will experience mental health issues, and yet only 1 in 6 children will receive treatment iii
• 70% of mental health problems begin in childhood iv
• Engaging in services early can lead to health care/support service savings of $140,000 per child. v
• Between 2006 and 2014, visits for addiction and mental health care increased in children by 53% vi
If you or someone you know needs mental health support, contact your local doctor. The following websites explore children’s mental health service supports in the Northumberland, Hastings and Prince Edward County areas:
Addictions and Mental Health Services
Children’s Health and Youth Services Network
Children’s Mental Health Ontario
Quinte Health Care
Northumberland Hills Hospital
i Kid’s Help Phone 1-800-668-6868 Open Line, Open Mind 1-613-310-OPEN
iv MHASEF Research Team. (2015) The Mental Health of Children and Youth in Ontario: A Baseline Scorecard. Institute for Clinical Evaluative Sciences.
v Centre for Addiction and Mental Health
vi Mental Health Commission of Canada www.ices.on.ca
*Matt and Brandon’s names have been changed to protect their identities